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24th May 2025
A 25-year-old male with no past medical history presents with a staggered overdose of paracetamol.
A 25-year-old male with no past medical history presents with a staggered overdose of paracetamol. You see the patient in the medical assessment unit 24 hours after admission. He received an infusion of acetylcysteine yesterday; despite this, he is very confused and speaking unintelligibly. He is clutching his stomach and crying out.
Blood results are shown below:
| Hb (135–180 g/L) | 135 | pH (7.35–7.45) | 7.32 | |
| WBC (4.0–11.0 × 10⁹/L) | 10.8 | pCO₂ (4.5–6.0 kPa) | 5.8 | |
| Platelets (150–400 × 10⁹/L) | 350 | pO₂ (10–14 kPa) | 9.8 | |
| Na (135–145 mmol/L) | 136 | HCO₃⁻ (22–26 mmol/L) | 20 | |
| K (3.5–5.0 mmol/L) | 5.4 | Lactate (<2.0) | 2.1 | |
| Cr (55–120 µmol/L) | 320 | |||
| PT (10–14 secs) | 101 | |||
| APTT (25–35 secs | 45 | |||
What single treatment would be most appropriate for this patient?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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